On-Call Water Repairs, addenda 1 issued - MASSDOT required

CERTIFICATION OF COMPLIANCE
G.L.c.30, 39S :
'PUBLIC CONSTRUCTION MORE THAN $10,000.00

I certify under the pains and penalties of perjury that:

1. the Contractor is able to furnish Jabor that can work in harmony with al) other
elements of labor employed or to be employed in the work;

2. all employces to be employed at the worksite will have successfully completed a
course in construction safety and health approved by the United States
Occupational Safety and Health Administration ("OSHA") that is at least 10
hours in duration and the time the employee begins works and who shall furnish
documentation of successfil completion of said course with the first certified
payroll report for each employee; and

3, that all employees to be employed in the work subject to this bid have
successfully completed a course in construction safety and health approved by
OSHA that is at least 10 hours in duration.

a ' a
Signature of Individual or Corporate By: Corporate Officer

'Name (Mandatory) (Mandatory, if applicable)

Approval of a contact or other agreement will not be granted unless this certification
clause is signed by the applicant.